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The Women’s War

Suzanne Swift Just before she was to leave for her second tour in Iraq, she told her mother: "I can't do this. I can't go back there."Credit
Katy Grannan for The New York Times

On the morning of Monday, Jan. 9, 2006, a
21-year-old Army specialist named Suzanne Swift
went AWOL. Her unit, the 54th Military Police
Company, out of Fort Lewis, Wash., was two days
away from leaving for Iraq. Swift and her
platoon had been home less than a year, having
completed one 12-month tour of duty in February
2005, and now the rumor was that they were
headed to Baghdad to run a detention center. The
footlockers were packed. The company's 130
soldiers had been granted a weekend leave in
order to go where they needed to go, to say
whatever goodbyes needed saying. When they
reassembled at 7 a.m. that Monday, uniformed and
standing in immaculate rows, Specialist Swift,
who during the first deployment drove a Humvee
on combat patrols near Karbala, was not among
them.

Swift would later say that she had every
intention of going back to Iraq. But in the
weeks leading up to the departure date, she
started to feel increasingly anxious. She was
irritable, had trouble sleeping at night, picked
fights with friends, drank heavily. ''I was
having a lot of little freakouts,'' she told me
when I went to visit her in Washington State
last summer. ''But I was also ready to go. I was
like, 'O.K., I can do this.'''

The weekend before the deployment was to start,
however, Swift drove south to her hometown,
Eugene, Ore., to visit with her mother and three
younger siblings. The decision to flee, she
says, happened in a split second on Sunday
night. ''All my stuff was in the car,'' she
recalls. ''My keys were in my hand, and then I
looked at my mom and said: 'I can't do this. I
can't go back there.' It wasn't some rational
decision. It was a huge, crazy, heart-pounding
thing.''

For two days after she failed to report, Swift
watched her cellphone light up with calls from
her commanders. They left concerned messages and
a few angry ones too. She listened to the
messages but did not return the calls. Then
rather abruptly, the phone stopped ringing. The
54th MP Company had left for Iraq. Swift says
she understood then the enormity of what she'd
just done.

For the remainder of that winter, Swift hid out
in the Oregon seaside town of Brookings, staying
in a friend's home, uncertain whether the Army
was looking for her. ''I got all my money out of
the bank,'' she told me. ''I never used my
credit card, in case they were trying to trace
me. It was always hanging over my head.'' At her
mother's urging, she drove back to Eugene every
week to see a therapist. In April of last year,
she finally moved back into her family's home.
Then, on the night of June 11, a pair of local
police officers knocked on the door and found
Swift inside, painting her toenails with her
19-year-old sister. She was handcuffed, driven
away and held in the county jail for two nights
before being taken back to Fort Lewis, where
military officials threatened to charge her with
being absent without leave. As Army officials
pondered her fate, Swift was assigned a room in
the barracks and an undemanding desk job at Fort
Lewis.

Despite the fact that military procedure for
dealing with AWOL soldiers is well established -
most are promptly court-martialed and, if
convicted, reduced in rank and jailed in a
military prison - Suzanne Swift's situation
raised a seemingly unusual set of issues. She
told Army investigators that the reason she did
not report for deployment was that she had been
sexually harassed repeatedly by three of her
supervisors throughout her military service:
beginning in Kuwait; through much of her time in
Iraq; and following her return to Fort Lewis.
She claimed too to be suffering from
post-traumatic stress disorder, or PTSD, a
highly debilitating condition brought on by an
abnormal amount of stress. According to the most
recent edition of The Diagnostic and Statistical
Manual of Mental Disorders, used by
mental-health professionals to establish
diagnostic criteria, PTSD symptoms can include,
among other things, depression, insomnia or
''feeling constantly threatened.'' It is common
for those afflicted to ''re-experience''
traumatic moments through intrusive, graphic
memories and nightmares.

Swift's stress came not just from the war and
not just from the supposed harassment, she told
the investigators, but from some combination of
the two. In a written statement to
investigators, Swift asserted that her station,
Camp Lima, outside Karbala, was hit by mortar
attacks almost nightly for the first two months
of her deployment. She reported working 16-hour
shifts, experiencing the death of a fellow
company member in an incident of friendly fire
and having a close friend injured in a car
bombing. What Swift said distressed her most,
however, was a situation that involved her squad
leader, the sergeant to whom she directly
reported in Iraq. She claimed that he
propositioned her for sex the first day the two
of them arrived in Iraq and that she felt
coerced into having a sexual relationship with
him that lasted four months - the relationship
consisting, she said, of his knocking on her
door late at night and demanding intercourse.
When she finally ended this arrangement, Swift
told me, the sergeant retaliated by ordering her
to do solitary forced marches from one side of
the camp to another at night in full battle gear
and by humiliating her in front of her fellow
soldiers. (The sergeant could not be reached,
but according to an internal Army report, he
denied any sexual contact with Swift.)

As it often is with matters involving sex and
power, the lines are a little blurry. Swift does
not say she was raped, exactly, but rather
manipulated into having sex - repeatedly - with
a man who was above her in rank and therefore
responsible for her health and safety. (Some
victims' advocates use the term ''command rape''
to describe such situations.) Swift says that
the other two sergeants - one in Kuwait and one
back home in Fort Lewis, both a couple of ranks
above her - made comments like ''You want to
[expletive] me, don't you?'' or when Swift asked
where she was to report for duty, responded,
''On my bed, naked.''

In the wake of several sex scandals in the
1990s, the U.S. military has tried to become
more sensitive to the presence of women,
especially now that they fill 15 percent of the
ranks worldwide. There are regular mandated
workshops on preventing sexual harassment and
assault. Each battalion has a designated Equal
Opportunity representative trained to field and
respond to complaints. Swift said she initially
reported what she characterized as an unwanted
relationship with her squad leader in Iraq to
her Equal Opportunity representative there, who
listened - she claims - but did nothing about
it. (According to the internal report, the E.O.
representative told investigators that he asked
Swift if she had a complaint to make but that
she declined at the time.)

Swift made it clear that since enlisting in the
Army when she was 19, she'd grown accustomed to
hearing sexually loaded remarks from fellow
enlisted soldiers. It happened ''all the time,''
she said. But coming from her superiors,
especially far away from the support systems of
home and against a backdrop of mortar attacks
and the general uncertainties of war, the
overtones felt more threatening. ''You can tell
another E-4 to go to hell,'' she said, referring
to the rank of specialist. ''But you can't say
that to an E-5,'' she said, referring to a
sergeant. ''If your sergeant tells you to walk
over a minefield, you're supposed to do it.''

I went to see Swift last July as I was immersed
in a series of interviews with women who'd gone
to Iraq and come home with PTSD. I was trying to
understand how being a woman fit into both the
war and the psychological consequences of war.
The story I heard over and over, the dominant
narrative really, followed similar lines to
Swift's: allegations of sexual trauma, often
denied or dismissed by superiors; ensuing
demotions or court-martials; and lingering
questions about what actually occurred.

Swift and I - along with her mother, Sara Rich -
met at a run-down sushi place in Tacoma, Wash.,
not far from Fort Lewis. Swift has blond hair,
milky skin and clear green eyes, which lend her
the vague aspect of a Victorian doll - albeit a
very tough one. She curses freely, smokes
Newports and, when she's not in uniform, favors
low-cut shirts that show off an elaborate flower
tattoo on her chest. ''Suzanne is not some
passive little lily,'' explained her mother.
''She's a soldier.''

By midsummer of last year, the two women had
settled into a ritual: once a week Rich would
pick up her daughter at the base and take her
out for a meal, and then the two would check
into a nearby Holiday Inn, talking and watching
television and finally going to sleep. At 6:30
the following morning, Swift would put on her
uniform and Rich would drive her back to Fort Lewis in time to report for work.
Rich, who is 41, is a social worker who
specializes in family therapy and operates with
a certain type of mama-bear verve. She was in
frequent touch last summer with her daughter's
Chicago-based lawyers, who were then negotiating
with the Army to get Swift medically discharged
for her PTSD so that she could avoid being
court-martialed and convicted for going AWOL. In
the six weeks since Swift's arrest, Rich
marshaled both legal funds and public sympathy
for her daughter's defense, largely by tapping
into the outrage fulminating inside the antiwar
movement. One of Rich's friends from Eugene
built a Web site devoted to Suzanne, taking both
donations and online signatures for a petition
to have her released from the Army without
punishment. Someone else started selling
T-shirts, tote bags and teddy bears that read
''Free Suzanne'' and ''Suzanne's My Hero'' to
benefit the cause.

At that point, the hullabaloo was doing little
good. A week before I arrived in Washington, the
Army's investigation determined that Swift's
charges against two of her higher-ups, including
the one Swift said demanded sex from her, could
not be substantiated because of a lack of
evidence. (Both men denied Swift's allegations.
By the time the investigation began, in June
2006, her squad leader had already finished his
military service, which put him beyond the reach
of punishment by the military anyway.) There was
a third sergeant against whom Swift filed a
formal harassment complaint in the spring of
2005, nearly a year before she went AWOL. In it
she maintained that immediately following her
unit's return from Iraq, he began making
frequent suggestive remarks to her and at one
point, during the course of a normal workday,
''grinded'' his body against hers in an
inappropriate way. That man received a
stridently worded letter of reprimand on May 25,
2005, from a lieutenant colonel and was
transferred away from Fort Lewis.

What still remained to be determined was whether
Swift would be held accountable for going AWOL
or whether the Army would accept the idea that
her failure to report was, as she saw it, an
instinctive act of psychological
self-preservation. Whatever the case, Swift was
quickly becoming a symbol - though of what it
was hard to say. Among the antiwar crowd, thanks
in part to the fiery speeches Swift's mother was
delivering at local rallies and antiwar
gatherings, she was being painted as a martyr, a
rebel and a victim all at once. Meanwhile,
others deemed her a traitor, a fraud or simply a
whiny female soldier who'd been too lazy or too
selfish to return to war.

Swift herself seemed stunned by the attention.
''Look at me, a poster child,'' she told me
wryly, making it clear that she was not enjoying
it. She did not make the kind of grandiose
anti-military statements her mother did but
rather seemed to be trying to shrug off what
happened to her. She told me she was having
nightmares and was sometimes waylaid by fits of
hysterical crying. But she described these
flatly, seeming almost unwilling or unable to
express anger or hurt. Overall, she seemed
strikingly detached.

I had read enough about PTSD to know that
''emotional numbing'' is one of the disorder's
primary symptoms, but it made understanding
Swift and what she'd been through a more
difficult task. ''Avoidance'' is another
commonly recognized symptom in people with PTSD,
especially avoidance of those things that bring
reminders of the original trauma. If the Iraq
war and the men she encountered there and
afterward traumatized Swift, then perhaps going
AWOL could be seen as a sort of meta-avoidance
of all that plagued her.

That night after dinner, Swift lay on her hotel
bed with her shoes kicked off, staring blankly
at the ceiling. She was thoughtful and willing
to answer questions. A few times, describing her
deployment, she hovered close to tears but then
seemed promptly to swallow them. She told me
that she came home from Iraq feeling demoralized
and depressed. She resumed her stateside duties
with the Army for the 11 months between
deployments and in general ''just tried to
deal.''

She was not, however, formally given a diagnosis of PTSD until after she went
AWOL - first by a civilian psychiatrist within days of her failure to report
for deployment and later, Swift says, through the Army's mental-health division
at Fort Lewis. (The Army could not confirm this, citing privacy issues.) The
timing raised a serious question: Was the PTSD a legitimate disability or a
hastily crafted excuse for skipping out on the war? Nobody, perhaps not even
Swift, could say for sure.

II. The 'Double Whammy'

No matter how you look at it, Iraq is a chaotic
war in which an unprecedented number of women
have been exposed to high levels of stress. So
far, more than 160,000 female soldiers have been
deployed to Iraq and Afghanistan, as compared
with the 7,500 who served in Vietnam and the
41,000 who were dispatched to the gulf war in
the early '90s. Today one of every 10 U.S.
soldiers in Iraq is female.

Despite the fact that women are generally
limited to combat-support roles in the war, they
are arguably witnessing a historic amount of
violence. With its baffling sand swirl of
roadside bombs and blind ambushes, its civilians
who look like insurgents and insurgents who look
like civilians, the Iraq war has virtually
eliminated the distinction between combat units
and support units in the military. ''Frankly one
of the most dangerous things you can do in Iraq
is drive a truck, and that's considered a
combat-support role,'' says Matthew Friedman,
executive director of the National Center for
PTSD, a research-and-education program financed
by the Department of Veterans Affairs. ''You've
got women that are in harm's way right up there
with the men.''

There have been few large-scale studies done on
the particular psychiatric effects of combat on
female soldiers in the United States, mostly
because the sample size has heretofore been
small. More than one-quarter of female veterans
of Vietnam developed PTSD at some point in their
lives, according to the National Vietnam
Veterans Readjustment Survey conducted in the
mid-'80s, which included 432 women, most of whom
were nurses. (The PTSD rate for women was 4
percent below that of the men.) Two years after
deployment to the gulf war, where combat
exposure was relatively low, Army data showed
that 16 percent of a sample of female soldiers
studied met diagnostic criteria for PTSD, as
opposed to 8 percent of their male counterparts.
The data reflect a larger finding, supported by
other research, that women are more likely to be
given diagnoses of PTSD, in some cases at twice
the rate of men.

Experts are hard pressed to account for the
disparity. Is it that women have stronger
reactions to trauma? Do they do a better job of
describing their symptoms and are therefore
given diagnoses more often? Or do men and women
tend to experience different types of trauma?
Friedman points out that some traumatic
experiences have been shown to be more
psychologically ''toxic'' than others. Rape, in
particular, is thought to be the most likely to
lead to PTSD in women (and in men, in the rarer
times it occurs). Participation in combat,
though, he says, is not far behind.

Much of what we know about trauma comes
primarily from research on two distinct
populations - civilian women who have been raped
and male combat veterans. But taking into
account the large number of women serving in
dangerous conditions in Iraq and reports
suggesting that women in the military bear a
higher risk than civilian women of having been
sexually assaulted either before or during their
service, it's conceivable that this war may well
generate an unfortunate new group to study -
women who have experienced sexual assault and
combat, many of them before they turn 25.

A 2003 report financed by the Department of
Defense revealed that nearly one-third of a
nationwide sample of female veterans seeking
health care through the V.A. said they
experienced rape or attempted rape during their
service. Of that group, 37 percent said they
were raped multiple times, and 14 percent
reported they were gang-raped. Perhaps even more
tellingly, a small study financed by the V.A.
following the gulf war suggests that rates of
both sexual harassment and assault rise during
wartime. The researchers who carried out this
study also looked at the prevalence of PTSD
symptoms - including flashbacks, nightmares,
emotional numbing and round-the-clock anxiety -
and found that women who endured sexual assault
were more likely to develop PTSD than those who
were exposed to combat.

Photo

Keli Frasier
I didnt really start having mental issues
until we got home, says the Army
reservist (here with her son), who watched
her squad leader die in Iraq.Credit
Katy Grannan for The New York Times

Patricia Resick, director of the Women's Health
Sciences Division of the National Center for
PTSD at the Boston V.A. facility, says she
worries that the conflict in Iraq is leaving
large numbers of women potentially vulnerable to
this ''double whammy'' of military sexual trauma
and combat exposure. ''Many of these women,''
she says, ''will have both.'' She notes that
though both men and women who join the military
have been shown to have higher rates of sexual
and physical abuse in their backgrounds than the
general population, women entering the military
tend to have more traumas accumulated than men.
One way to conceptualize this is to imagine that
each one of us has a psychic reservoir for
holding life's traumas, but by some
indeterminate combination of genetics and
socioeconomic factors, some of us appear to have
bigger reservoirs than others, making us more
resilient. Women entering the military with
abuse in their backgrounds, Resick says, ''may
be more likely to have that reservoir half
full.''

Over the last few years, I've spoken at length
with more than a dozen trauma specialists,
questioning them about the effect this war will
have on the psyches of the women who have fought
in it. The prevailing answer is ''We just don't
know yet.'' The early reports for both sexes,
though, are troubling. The V.A. notes that as of
last November, more than one-third of the
veterans of Iraq and Afghanistan treated at its
facilities were given diagnoses of a
mental-health disorder, with PTSD being the most
common. So far, the V.A. has diagnosed possible
PTSD in some 34,000 Iraq and Afghanistan
veterans; nearly 3,800 of them are women. Given
that PTSD sometimes takes years to surface in a
veteran, these numbers are almost assuredly
going to grow. With regard to women, nearly
every expert I interviewed mentioned the
reportedly high rates of sexual harassment and
assault in the military as a particular concern.

The Department of Defense in recent years has
made policy changes designed to address these
issues. In 2005 it established a formal Sexual
Assault Prevention and Response program, and
trains ''Victim Advocates'' on major military
installations. The rules have also been
rewritten so that victims are now able to report
sexual assaults confidentially in ''restricted
reports'' that give them access to medical
treatment and counseling without setting off an
official investigation. The results could be
viewed as both encouraging and disturbing:
comparing figures from 2005, when the restricted
reporting began, to those of 2004, the number of
reported assaults across the military jumped 40
percent, to 2,374. While victims may be feeling
more empowered to report sexual assault, it
appears that the number of assaults are not
diminishing.

If Suzanne Swift's why-bother approach to
telling her superiors about the harassment in
Iraq initially struck me as curious, it began to
make more sense as I spoke with a number of
other female Iraq veterans. There was a
pervasive sense among them that reporting a
sexual crime was seldom worthwhile. Department
of Defense statistics seem to bear this out: of
the 3,038 investigations of military sexual
assault charges completed in 2004 and 2005, only
329 - about one-tenth - of them resulted in a
court-martial of the perpetrator. More than half
were dismissed for lack of evidence or because
an offender could not be identified, and another
617 were resolved through milder administrative
punishments, like demotions, transfers and
letters of admonishment.

Unaware of the actual numbers, many of the women I talked to seemed, in any
event, to have soaked up a larger message about the male-dominated military
culture. ''Saying something was looked down upon,'' says Amorita Randall, who
served in Iraq in 2004 with the Navy, explaining why she did not report what
she says was a rape by a petty officer at a naval base on Guam shortly before
she was deployed to Iraq. ''I don't know how to explain it. You just don't expect
anything to be done about it anyway, so why even try?''

III. The Pressure of Being a Woman

Many of the women I spoke with said they felt the burden of having to represent
their sex - to defy stereotypes about women somehow being too weak for military
duty in a war zone by displaying more resiliency and showing less emotion than
they otherwise might. There appears to have been little, too, in the way of
female bonding in the war zone: most reported that they avoided friendships
with other women during the deployment, in part because of the fact that there
were fewer women to choose from and in part because of the ridicule that came
with having a close friend. ''You're one of three things in the military - a
bitch, a whore or a dyke,'' says Abbie Pickett, who is 24 and a combat-support
specialist with the Wisconsin Army National Guard. ''As a female, you get classified
pretty quickly.''

Many women mentioned being the subject of crass
jokes told by male soldiers. Some said that they
used sarcasm to deflect the attention but that
privately the ridicule wore them down. Others
described warding off sexual advances again and
again. ''They basically assume that because
you're a girl in the Army, you're obligated to
have sex with them,'' Suzanne Swift told me at
one point.

There were women, it should be noted, who spoke
of feeling at ease among the men in their
platoons, who said their male peers treated them
respectfully. Anecdotally, this seemed most
common among reserve and medical units, where
the sex ratios tended to be more even. Several
women credited their commanders for establishing
and enforcing a more egalitarian climate, where
sexual remarks were not tolerated.

This was not the case for Pickett, who arrived
in Iraq early in 2003, having been sexually
assaulted, she said, during a humanitarian
deployment to Nicaragua less than two years
earlier, when she was just 19. When I spoke to
her by phone in December, she recalled being too
afraid to report the incident, particularly
given the fact that the supposed perpetrator was
an officer who ranked above her. During her
11-month stint in Iraq, stationed mostly outside
Tikrit in a company of 19 women and 140 men,
Pickett claimed her male peers thought nothing
of commenting on her breast size or making
sexual jokes about her. She regularly
encountered porn magazines sitting in the
latrines and in common areas. None of this
behavior was particularly new to her; it was
life as she knew it in the military. Yet in a
war zone the effect seemed more corrosive. ''The
real difference is that over there, there's
never a break from it,'' Pickett told me. ''At
home, you can go out with your girlfriends and
get a beer and talk about the idiots who were
cracking jokes. Over there, you're a minority 24
hours a day, seven days a week. You never get
that 10 minutes to relax or even cry. Sometimes
you just need to let it all out.''

One night in the fall of 2003, Pickett recalled,
her unit endured a mortar attack. Trained as a
combat lifesaver, she spent part of the night
tending to bleeding soldiers by flashlight in a
field tent. Once the experience was over, the
memory kept replaying in her mind. ''For a long
time, I wished I had died that night,'' Pickett
told me, adding that she returned to her home in
Wisconsin and was ''barely functioning''- unable
to sleep or concentrate. She spent days alone
inside her apartment, not talking to anyone. ''I
was draining everyone around me,'' she says. A
year after her deployment, a V.A. clinician
formally diagnosed PTSD, which Pickett says she
thinks stems from the stress of combat,
harassment and the earlier sexual assault.
If Vietnam became notorious as a war that
combined violence and sex, with Southeast Asian
brothels being the destination of choice for
soldiers on temporary leave from the war, the
sexual politics of the Iraq war are, as of yet,
unclear.

Joane Nagel, a sociology professor at the
University of Kansas, is studying sex and the
military as it pertains to the Iraq war. What
she has found, she told me recently, is that
''when you take young women and drop them into
that hypermasculine environment, the sex stuff
just explodes. Some have willing sex. Some get
coerced into it. Women are vulnerable sexually.''
The specter of childhood abuse in military men
and women potentially adds another layer of
combustibility to gender relations. Tina Lee, a
psychiatrist at the V.A. Palo Alto Health Care
System in California, works with both male and
female PTSD patients. She points out that
traumatic experiences in childhood may increase
the risk of developing PTSD when exposed to
another trauma in adulthood. Experiencing
childhood trauma can also produce opposing
behaviors in adult men and women. Male survivors
of childhood abuse are more likely to act
aggressively and angrily, while some women
appear to lose their self-protective instincts.
A female patient, she says, once offered up an
apt description of this tendency to end up in
hurtful situations, saying that her ''people
picker'' had been broken.

''So you have young women joining the military
who have the profile of being victimized, who
don't have boundaries sometimes,'' Lee went on
to say. ''And then you have a male population
that fits a perpetrator profile. They are mostly
under 25, often developmentally adolescent, and
you put them together. What do you think will
happen? The men do the damage, and the women
get damaged.''

Being sexually assaulted by a fellow soldier may
prove extra-traumatic, as it represents a breach
in the hallowed code of military cohesion - a
concept that most enlistees have drilled into
them from the first day of boot camp. ''It's
very disconcerting to have somebody who is
supposed to save your life, who has your back,
turn on you and do something like that,'' says
Susan Avila-Smith, the director of Women
Organizing Women, an advocacy program designed
to help traumatized women navigate the vast V.A.
health-care and benefits system. ''You don't
want to believe it's real. You don't want to
have to deal with it. The family doesn't want to
deal with it. Society doesn't want to deal with
it.''

Pickett, who since returning from Iraq has become active in Iraq and Afghanistan
Veterans of America, a nonpartisan advocacy group, says she believes that the
stress of just worrying about this puts a woman in danger. ''When I joined the
military, a lot of people at home said things like, 'Oh, are you really going
to be able to handle it?''' she said. ''So then you're in Iraq, driving down
Highway 1 with an M-16 in your hand. You have those doubts people had about
you in the back of your head. You're thinking 5,000 things at once, trying to
be everything everybody wants you to be. And you still have to take the crap
from the men. You're 20 years old and growing into your own body, having an
actual sex drive. But you've got 30 horny guys propositioning you and being
really disgusting about it.'' She added: ''Women are set up to fail in a very
real way, in an area where they could get killed. If your mind isn't 100 percent
on the battlefield, you could die. That's the bottom line.''

IV. Flickers of a Larger Fire

Three years ago, while researching an article for this magazine on injured
soldiers who fought in Iraq, I happened to have a phone conversation with a
woman from Michigan who served as a reservist in the gulf war. Like many people,
she'd been watching coverage of the war in Iraq with concern. At the time, I
was focused on the early waves of soldiers returning home with horrendous, debilitating
injuries - the amputees, the paraplegics, the brain-injured - but she was worried
about something entirely different, equally devastating but far less visible.

She used her own story as an example: While
serving in a mostly male reserve unit in Kuwait,
she told me, she was sexually assaulted. After
returning home to Michigan, she began exhibiting
symptoms of PTSD - jumpiness, intrusive thoughts
and nightmares - and promptly went to her local
V.A. hospital for help. She was then put into
group therapy - which has long been shown to be
an economical and reasonably effective way of
helping trauma survivors process their
experiences - but her ''group'' was made up
entirely of male Vietnam vets, some of whom were
trying to work through sex crimes they committed
during military service. Others came home from
war and beat their wives. ''I freaked out,'' the
female reservist told me. ''It sent me into a
complete tailspin.''

She began to drink heavily. She lost her job,
moved away from her family and toyed with the
idea of suicide. Few PTSD stories are happy
stories, but this one eventually took a positive
turn: a therapist at her local V.A. hospital
finally referred her to a 10-bed residential
program for women with PTSD located in Menlo
Park, Calif. Desperate for help, she spent a
number of weeks there, receiving daily therapy
and learning coping skills in the company of a
small group of other female veterans and a staff
of mostly female therapists. The experience, she
told me, saved her life.

Following the early coverage of the Iraq war,
however, she was feeling her PTSD begin to stir
again. Jessica Lynch - who, it was reported,
might have been sexually assaulted as a prisoner
of war in the first weeks after the invasion -
was being celebrated as a hero. TV news reports
showed female soldiers bidding farewell to their
spouses and children. All this woman in Michigan
could think about, though, was what things would
look like on the other side, whether the V.A.
would know what to do with these women if they
later turned up needing help - whether, in
particular, sexual-assault victims would be
retraumatized trying to find their way in a
system that was built almost entirely around the
needs of men.

Thomas Berger, national chairman of Vietnam
Veterans of America's PTSD-and-substance-abuse
committee, told me recently: ''I think women are
more likely to fall through the cracks. The fact
is, if a woman veteran comes in from Iraq who's
been in a combat situation and has also been
raped, there are very few clinicians in the V.A.
who have been trained to treat her specific
needs.''

As the Iraq war creates tens of thousands of
female war veterans, surely we will begin to
know more about the impact of PTSD on the life
of a military woman. Female soldiers have flown
fighter jets, commanded battalions, lost limbs,
survived stints as P.O.W.'s, killed insurgents
and also come home in flag-covered caskets. And
many, too, have begun to experience the psychic
fallout of war, a concept made famous
post-Vietnam by a generation of now middle-aged
men. ''We're much more willing to acknowledge
what guys do in combat - both the negative and
the heroic,'' says Erin Solaro, author of the
2006 book ''Women in the Line of Fire.'' ''But
as a culture, we're not yet willing to do that
for women. Female combat vets tend to be very
lonely people.''

Sexual trauma by itself or in combination with
combat stands to isolate a female vet further,
says Avila-Smith, the veterans' advocate. ''If
you're in combat, you can talk about it in group
therapy,'' she told me. ''You can say, 'Yeah, I
was in this battle and I saw my friends blown
up,''' she says. ''But nobody raises their hand
and yells out in the middle of the V.A.: 'Yeah,
I was raped in the military, was anybody else?
Do we have something in common?'''
Avila-Smith herself says she was sexually
assaulted while stationed in Texas in 1992 and
developed PTSD as a result. For a long time,
everyday functioning was a challenge. ''For two
years I had a list on my bathroom mirror to
brush my teeth, brush my hair, wash my face,''
she said as we sat at a sunny picnic table
outside a V.A. hospital in Seattle. ''Every
morning it was like waking up in a new world.
How did I get here? What's going on? Why is my
brain not working?''

This kind of bewilderment is something I
encountered again and again, talking to more
than 30 military women who struggle with PTSD.
Whether they had just returned from Iraq or were
25 years past their service, whether they'd been
sexually assaulted, seen combat or both, most
reported feeling forgetful and unfocused,
alienated from their own minds.

Keli Frasier, an Army reservist living in
Clifton, Colo., who said she did not experience
sexual assault, told me that because of some
combination of anxiety and memory loss, she'd
been fired from three low-wage jobs and dropped
out of college since returning from Iraq in May
2004. Like a few of the others I met, Frasier
always kept a notebook close by to jot down
things she was afraid she'd forget. ''Half the
time,'' she said, sounding genuinely confused,
''I don't understand why I lose the jobs.''
According to her account, while driving a fuel
truck in Iraq, she watched her squad leader die
in a roadside ambush and another peer have his
leg blown off with a grenade. ''In all those
situations, your mind just goes on autopilot,
and you just do what you're trained to do,'' she
said, sitting on a couch in a warmly decorated
trailer she and her husband own. She bounced her
8-month-old son on one knee as she talked. ''I
didn't really start having any mental issues
until we got home,'' she said, adding that it
was four or five months before PTSD was
diagnosed by a V.A. counselor.

Research has shown that exposure to trauma has
the potential to alter brain chemistry,
affecting among other things the way memories
are processed and stored. To vastly simplify a
complex bit of neurology: If the brain can't
make sense of a traumatic experience, it may be
unable to process it and experience it as a
long-term memory. Traumas tend to persist as
emotional - or unconscious - memories, encoded
by the amygdala, the brain's fear center. A
trauma can then resurface unexpectedly when
triggered by a sensory cue. The cerebral cortex,
where rational thought takes place, is not in
control. The fear center rules; the brain is
overwhelmed. Small tasks - tooth-brushing,
grocery-shopping, feeding your children - start
to feel monumental, even frightening.

''I was not scared a single day I was in Iraq;
that's what baffles me most,'' Kate Bulson, a
24-year-old former Army sergeant, told me by
phone not long ago from her home in Muskegon,
Mich. She developed PTSD after completing the
first of two tours in Iraq, she said, adding
that she had not experienced sexual trauma. ''I
did everything the male soldiers did: I kicked
in doors, searched people and cars, ran patrols
on dangerous highways,'' she said. ''Over there,
I would hear an explosion at night and sleep
through it. Now I hear the slightest sound and I
wake up.''

Photo

Kathleen
I was worried how children of parents who
commit suicide have a higher rate of
suicide themselves, says the mother of five, who
as an Army nurse tended to wounded Iraqi
children. But if I died because of
the enemy, then that would be acceptable.Credit
Katy Grannan for The New York Times

Just last month, The Journal of the American
Medical Association published the results of a
study sponsored by the V.A., which endorsed the
use of ''prolonged exposure therapy'' in
treating female veterans with PTSD. The process
calls for a patient to visit and revisit
traumatic memories in order to lessen their
power over the mind. ''It becomes an organized
story rather than a fragmented story,'' says
Edna Foa, who directs the Center for the
Treatment and Study of Anxiety at the University
of Pennsylvania and is considered a pioneer in
trauma treatment. ''They are able to put things
together. They find all kinds of new
perspectives to look at what happened to them.''

Across the V.A., there appears to be an earnest
recognition of the need for stepping up these
innovative programs for veterans of both sexes.
V.A.-financed researchers are working on
everything from testing a drug normally used to
treat tuberculosis on PTSD patients to
developing virtual-reality war simulations that
are meant to give veterans more emotional
control over their traumatic memories. Of the
some 1,400 V.A. hospitals and clinics, currently
only 27 house inpatient PTSD programs, and of
these, just 2 serve women exclusively. According
to the V.A., several more women's residential
treatment programs are in the planning stages.

Despite fighting wars in two far-off countries,
the Bush administration recently announced that
while it will increase V.A. health-care
financing by 9 percent for 2008, it has proposed
consecutive cuts of about $1.8 billion for 2009
and 2010. Moreover, as recent revelations of
poor patient care at the military's flagship
facility, Walter Reed Army Medical Center, have
demonstrated, a federal health-care system built
to serve soldiers and veterans is sagging under
the load of those who fought in Iraq and
Afghanistan, a significant number of whom
struggle with mental-health issues. The V.A.
currently has a reported backlog of 400,000
benefits claims, which can in turn lead to long
waits for appointments or for approval for
medications. When I met her in January, Keli
Frasier, the Army reservist, described herself
as ''really having a hard time'' but had been
waiting two months to get an appointment to have
an expired antidepressant prescription renewed.

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It's possible, too, that female veterans suffer
from more invisibility. Patricia Resick, at the
Boston V.A. hospital, says she feels that women
may perhaps take longer than men to recognize
their symptoms and find their way into
treatment. ''They're more likely to have a
primary parenting role,'' she told me. ''When
they get home, they're going to be trying to get
back into their families, to re-establish their
relationships.'' Lee, the psychiatrist in Palo
Alto, says that in her experience, men are more
likely to have been encouraged to seek help,
usually by their spouses. ''You don't hear as
much about husbands saying, 'Honey, why don't
you go into residential treatment for two
months?''' she says. And those who feel shame
following a sexual trauma, Lee went on to say,
may keep it hidden from their health-care
providers anyway.

The larger question is: How will this new crop
of female war veterans respond, recover or act
out the traumas of their military experience?
While it is still too early to know, paying
attention to small stories, usually tucked
inside local newspapers, may indicate the early
flickers of a larger fire. There is the story of
Tina Priest, a 21-year-old soldier who,
according to Army investigation records, shot
herself with an M-16 rifle in Iraq last March,
two weeks after filing a rape charge against a
fellow soldier and days after being given a
diagnosis of ''acute stress disorder consistent
with rape trauma.'' (The Army says that a
subsequent investigation failed to substantiate
the rape claim.)

There is the story of Linda Michel, a
33-year-old Navy medic who served under
stressful conditions at a U.S.-run prison near
Baghdad and was given Paxil for depression
during the deployment. Returning home last
October, she struggled to fit back into her life
as a suburban mother of three in a quiet housing
development outside of Albany. She shot and
killed herself within three weeks of the
homecoming. Her husband, also an Iraq veteran,
wondered aloud to a reporter with The Albany
Times-Union: ''Why wasn't she sent to a facility
to resolve the issues?''

More recently, there's Jessica Rich, a 24-year-old former Army reservist who
one night early last month climbed drunk into her Volkswagen Jetta and drove
south on a northbound interstate outside of Denver. She slammed head-on into
a sport-utility vehicle, killing herself and slightly injuring four others.
After a nine-month tour of Iraq in 2003 - and according to former soldiers who'd
been in group therapy with her, having been raped during her service - PTSD
was diagnosed. Her friends say she never got past those experiences. ''She was
having nightmares still, up until this point - flashbacks and anxiety and everything,''
one told The Denver Post. ''She said it was really hard to get over because
she couldn't get any help from anybody.''

V. 'What's Wrong With Me?'

Earlier this winter, hoping to understand more about PTSD and its effects,
I visited a couple of female Iraq vets who felt their postwar lives had been
shaped - if not temporarily ruined - by the ''double whammy'' of combat and
sexual stress. Both happened to live in Colorado, though each had deployed to
war through units located in other states. I met Keri Christensen one morning
at her home in a tidy subdivision outside of Denver, where she recently relocated
from Wisconsin with her husband and two daughters. She had just taken her daughters
to school, and her husband was away on a business trip.

Christensen is 33, blue-eyed and outwardly
perky, with an easy smile. By the time she was
deployed to war in 2004, she had finished 13
years of part-time service in the Wisconsin Army
National Guard as a heavy-equipment transporter.
Prior to her deployment in Iraq, she loved her
role in the military. ''Before we were married,
my husband was in awe of it,'' she said,
laughing. ''He was like, 'I met this girl and
she hauls tanks!''' She added that she was good
at what she did, receiving several awards over
the years. Beyond commitment to the Guard of one
weekend a month and two weeks' training each
summer, Christensen spent the previous six years
as a stay-at-home mom. Her life, she said, had
been a generally happy one.

But the stresses of deployment were surprisingly
manifest: she agonized over leaving her
daughters, who were then 6 and 2 years old.
Stationed in Kuwait, Christensen's unit ran
convoys of equipment back and forth from the
port to inside Iraq. ''It was really scary,''
she said, explaining that her convoy had been
mortared during an early mission. ''But it was
like, Hey cool, we're on a mission.'' Then one
day in February 2005, Christensen was
accidentally dragged beneath a truck trailer and
run over, breaking a number of bones in her foot
and injuring her knee and back. She was assigned
to a desk job in a tent in Kuwait, mostly
working the night shift. It was there, she said,
that a sergeant above her in her command - a man
she'd known for 10 years - began making comments
about her breasts and at one point baldly
propositioned her for sex.

Something inside of her broke, she said.
Christensen claims that she was punished for
even mentioning the situation to her company
commanders - written up for minor infractions;
accused, she says falsely, of being intoxicated
(for which she was demoted); and reassigned for
duty to an airfield near a mortuary, where she
occasionally helped load coffins of dead
soldiers onto planes bound for the U.S. (The
Wisconsin Army National Guard denied that
Christensen was punished for making a
sexual-harassment claim and stated that the
claim was investigated and dismissed for lack of
evidence.) Christensen says that a combination
of war stress, harassment and the reprisals that
followed were so upsetting and demoralizing that
she considered suicide on several occasions. Her
military records show that during her
deployment, she was given a diagnosis of
depression and PTSD.

After Christensen's experiences in Kuwait, she
allowed her military enlistment to expire, which
given that she was six years short of receiving
military retirement benefits, only added to her
pain. ''That was my career, and they stole it
from me,'' she said, sitting on an overstuffed
couch in the family room of her home, idly
fiddling with one of her children's stuffed
animals as she spoke. ''They make you feel like
you're crazy. And I'm not just the only one.
There's other women out there this has happened
to. Why is the attitude always 'Just shut up and
leave it alone'?''

Christensen had been home from war then for just
over a year, having returned to her life as a
stay-at-home mother, yet she could not shake
what the deployment had done to her - the
accident, the confusion and shame of her sexual
harassment, and then what she felt was an
ignominious demotion and marginalization after
reporting the incidents. And while there are
those whose image of PTSD is still tied to
Vietnam War movies - the province of men who
earned their affliction only after having their
best buddies die in their arms in a gush of
blood - Christensen shares the same diagnosis.
That is to say that no matter what constituted
her war experience, the aftermath was much the
same. She suffered from severe headaches and
forgetfulness. ''I feel like I'm always
forgetting something,'' she said. ''I leave the
house and I don't know if I've left something on
- the stove or a candle. I can't trust my
memory.'' She told me that her 8-year-old,
Madison, recently had to tell her the family's
new phone number. She'd lost friends and had
''rough spots'' with her husband. Afraid of
crowds, she started grocery shopping at 6 in the
morning and was having her mother buy clothes
for her children. Driving, too, made her
fearful, since she felt ''foggy'' and more than
once ran a stop sign or a red light with her
kids in the car. Though she went for counseling
and medical treatment at a local V.A. while
living in Illinois after she returned from Iraq,
Christensen had not yet found her way to the
Denver V.A. for treatment. The thought of
getting in her car and making the 20-minute
drive petrified her.

Describing it, Christensen began to cry, wringing the stuffed animal in her
hands. ''What's wrong with me?'' she said, more to herself than to me. ''I have
nightmares of being trapped underneath a trailer with body parts falling on
me.'' Her body heaved with sobs as she continued: ''Once when my kids were sleeping
with me, I woke up suddenly, thinking it was an Iraqi person, and I almost tossed
my kid across the room.''

VI. 'Nothing Is Ever Clear'

Amorita Randall lives across the state from Christensen, in a small town outside
of Grand Junction. She is 27, a former naval construction worker who served
in Iraq in 2004. Over the course of several phone conversations before visiting
her in January, I grew accustomed to the way Randall coexisted with her memories.
Mostly she inched up to them. On days she was feeling stable, she would want
to talk, calling me up and abruptly jumping into stories about her six years
in the Navy, describing how she was raped twice - the second rape supposedly
taking place just a matter of weeks before she arrived in Iraq. Her experience
in Iraq, she said, included one notable combat incident, in which her Humvee
was hit by an I.E.D., killing the soldier who was driving and leaving her with
a brain injury. ''I don't remember all of it,'' she told me when I met her in
the sparsely furnished apartment she shares with her fiance?. ''I don't know
if I passed out or what, but it was pretty gruesome.''

According to the Navy, however, no after-action
report exists to back up Randall's claims of
combat exposure or injury. A Navy spokesman
reports that her commander says that his unit
was never involved in combat during her tour.
And yet, while we were discussing the supposed
I.E.D. attack, Randall appeared to recall it in
exacting detail - the smells, the sounds, the
impact of the explosion. As she spoke, her body
seemed to seize up; her speech became slurred as
she slipped into a flashback. It was difficult
to know what had traumatized Randall: whether
she had in fact been in combat or whether she
was reacting to some more generalized
recollection of powerlessness.

Either way, the effects seemed to be crippling. She lost at least one job and
was, like a number of the women I spoke to, living on monthly disability payments
from the V.A. Her fiance, an earnest construction worker named Greg Lund, at
one point discovered her hidden in a closet in the apartment they share, curled
in the fetal position, appearing frozen. ''It scared the hell out of me,'' he
said. ''I'm like, am I in over my head here?''' On another occasion, shopping
with Randall at Lowe's, he had to pull her away from a Hispanic man she mistook
for an Iraqi. ''She was going to attack him,'' Lund said. ''She was calling
him 'the enemy' and stuff like that.'' The biggest tragedy for her was that
her daughter, Anne, who is 4, was taken from her custody by the Colorado child-welfare
authorities after she was found playing in the road unsupervised one day last
June. At the time, Randall and her daughter were living with another family
in a halfway house. Randall was inside folding laundry, believing - she said
- that Anne was being watched by older children in the other family.

There were days when Randall couldn't remember
things, telling me her mind felt fuzzy.
Accordingly, when she broached a subject that
was difficult, her speech would slow down
markedly and sometimes stop altogether.
''Nothing is ever clear,'' she explained.
''Sometimes I'll just have feelings. Sometimes
I'll have pictures. Sometimes it'll be both.''
Her confusion could be both literal and moral.
She blamed herself, in part, for the rapes,
saying she felt peer pressure to drink heavily
in the Navy, which made her more vulnerable.

Randall's life story was a sad one, though
according to the V.A. psychologists I spoke
with, it was not atypical. Growing up in
Florida, she said, she was physically and
sexually abused by two relatives - a condition
that has been shown to make a woman more prone
to suffer assault as an adult. Eventually she
landed in foster care. She told me she joined
the Navy at 20 precisely because she was raised
in an environment where ''girls were
worthless.'' The stability and merit structure
of the military appealed to her. Stationed in
Mississippi in early 2002, Randall said, she was
raped one night in her barracks after being at a
bar with a group of servicemen. The details are
unclear to her, but Randall says she believes
that someone drugged her drink.

A couple of months later, she discovered she was
pregnant. In November 2002, she gave birth to
her daughter. Less than a year later, Randall's
unit was deployed to the war, stopping first for
several months on Guam. She put Anne in the care
of a cousin in Florida. The second rape happened
after another night of drinking. ''I couldn't
fight him off,'' Randall says. ''I remember
there were other guys in the room too. Somebody
told me they took pictures of it and put them on
the Internet.'' Randall says she has blocked out
most of the details of the second rape -
something else experts say is a common
self-protective measure taken by the brain in
response to violent trauma - and that she left
for Iraq ''in a daze.''

Given her low self-esteem and her tendency, as a trauma victim, to suffer from
fractured memory, someone like Randall would make an admittedly poor witness
in court. Randall claims that after returning from war, she told her commanders
about the second rape but says she was told ''not to make such a big deal about
it.'' (The Navy says it knows of no internal records indicating that she had
reported a sexual assault.) Since her daughter was removed from her custody
last summer, she had been going for weekly hourlong therapy sessions with a
civilian social worker, paid for by the V.A. She was also taking parenting classes
at a social-services agency and petitioning to have the child returned to her
care. Overall, she was feeling optimistic that through therapy, her PTSD was
beginning slowly to subside. But she also felt it was a case of too little,
too late, saying that before losing her daughter, she was receiving what for
many women is considered to be a standard course of mental-health treatment
in a V.A. system strapped for resources - a 60-minute counseling session held
every month. Randall shrugged, describing it. ''We never got very far with anything,''
she said, ''The guy would just ask me, 'So, how are you doing?' And I'd look
at him and say, 'Well ? I guess I'm fine.'''

VII. ''It Just Kept Building Up and Building Up ... ''

The Women's Trauma Recovery Program is tucked
into a small adobe-style building on one corner
of a sprawling V.A. health-care campus in Menlo
Park, Calif., about 20 miles south of San
Francisco. Outside there is a sunny courtyard,
where residents often gather to smoke and talk.
Inside there are five dorm-style bedrooms, each
with a pair of twin beds. The feeling is
something less than homey but something more
than institutional. Next door there is a larger
and more established 45-bed program for male
active-duty soldiers and veterans with PTSD.

When I arranged to visit the women's program for
a couple of days last July, it was unclear
whether any of the six female patients then in
residence would speak to me. According to Darrah
Westrup, the psychologist who leads the program,
this group had only just begun its 60-to-90-day
treatment program, which was devoted both to
learning coping skills and to gradually doing
exposure therapy for their traumas. For many of
the patients, entry in the program - gained
through a referral from a mental-health
specialist and then a fairly intensive
application process - felt like a last resort.
Privacy, too, was paramount: some of these women
had isolated themselves for years and, working
with the program's therapists, were just
beginning to rebuild some confidence, Westrup
said.

So it came as a surprise when, one by one, each
one surfaced at Westrup's office, ready to talk
to me. (They requested that I protect their
privacy by not using their full names.) Each
asked too that Westrup be present for the
interview, and I soon understood why: despite
the fact that conversation revolved mostly
around the impact of living with PTSD rather
than the traumatic events that caused it, the
danger of a flashback always lurked. ''Are you
here?'' Westrup would ask gently when somebody
appeared momentarily glazed or her speech slowed
down. ''Do you feel your feet on the ground?''

Some of the women served in previous decades and
were only now dealing fully with their PTSD.
They recognized themselves as harbingers, as
cautionary tales of how bad it could get for
those of the current generation of female
soldiers if they left their PTSD untreated. And
they repeated that sentiment again and again.
''I'm only talking to you,'' one said, ''because
I want other sisters to know they're not alone.''

Photo

Kate Bulson
Over there, I would hear an explosion at
night and sleep through it, says
the Army sergeant, who ran patrols. Now I hear
the slightest sound and I wake up.Credit
Katy Grannan for The New York Times

I met six women, two of whom served in Operation
Iraqi Freedom. Most hadn't seen combat, though
three of them said they were raped by fellow
soldiers during deployments in Germany, in
Japan, in Qatar. The women - Johnnie, Kathy,
Kathleen, Ann, Michelle and Sara - had served in
the Army, the Navy or the Air Force. What ran
through nearly every woman's story was a sense
of things left unresolved. Nobody mentioned
perpetrators being punished. Nearly everyone
expressed having gone through relentless
self-questioning: ''What if I hadn't accepted
that ride?'' one wondered aloud. ''What if I
hadn't drank so much?'' asked another.

According to Patricia Resick of the National
Center for PTSD, being able to process trauma is
the key to recovering from it. Those people who
cannot make sense of what happened to them are
more likely to continue reliving it through
flashbacks and intrusive memories. ''It's like a
record that keeps getting stuck,'' she said.
''They can't accept that it happened because of
the implications of accepting it. It means that
bad things - horrible things, really - can
happen to good people.''

The women in Menlo Park described, vividly, the
aftermath of living with unresolved military
trauma: Kathy was arrested more than once for
drunken driving. Michelle tried to kill herself
three times. Sara was put into a military
psychiatric hospital. Ann raised children and
had a successful career, but said that inside
her home in rural Northern California, she was
often so paralyzed by fear that she hid in the
closet any time the phone rang.

The program required that the women spend time
writing down their thoughts and then analyzing
them on paper, rooting out the ''distorted
thinking'' - things like feeling unworthy or
guilty - and then reinterpreting them in a more
healthful way. While each woman acknowledged
that the work was painful, there seemed to be a
kind of summer-camp camaraderie growing among
them. Yet there was always the notion looming
that at some point they, and their symptoms,
would need to return home.

One of the two vets of the Iraq war on the V.A.
campus was Kathleen, a 37-year-old Army nurse
with dark hair and fair skin. She arrived at
Menlo Park courtesy of a program sponsored by
the Department of Defense, in which active-duty
soldiers with severe PTSD are granted leave and
financing to pursue residential treatment
through the V.A. This is part of a larger effort
across the military to find and address
soldiers' mental-health issues as quickly as
possible. Kathleen was a first lieutenant and a
registered nurse based at Fort Sill, Okla. She
was medevacked out of Baghdad less than three
months earlier.

Sitting in a chair in Westrup's office, dressed
in a pastel T-shirt and jeans, Kathleen knit her
fingers together anxiously. Despite appearing
nervous, she seemed eager to talk. For better or
worse, Kathleen's trauma was still fresh. She
was also one of the few female veterans I spoke
with who were suffering from PTSD who did not
mention experiencing sexual harassment or
assault in the military, though she did allude
to ''a bad childhood.''

Speaking in a soft drawl, she described being
stationed at a combat support hospital inside
Baghdad's Green Zone, working 15-hour shifts in
the intensive-care unit, often tending to burn
patients who were helicoptered in from southern
Iraq. ''I expected some death,'' she said. ''I
was realistic. What I didn't expect was that we
would be taking care of so many civilians, and
those civilians would be children.'' She paused
to add that she had five children of her own -
all daughters, ages 9 to 18, who were back in
Oklahoma with her husband, himself an Army man
who'd been deployed to Iraq twice already.

In Baghdad, the stressors piled up quickly:
helicopters kept arriving from the south, burn
patients howled, children sometimes died. Lying
in bed at night, Kathleen listened to mortars
exploding and stray gunfire outside the Green
Zone. ''It just builds up and wears down on
you,'' she said. ''You're always in a heightened
adrenaline rush.''

Her hands started to tremble then. She mentioned
a young boy named Mohammed who died in the Green
Zone hospital early on in her time in Iraq,
saying only that she felt responsible for his
death. ''I can't say more about that,'' she
said, shaking her head. She then described
caring for another young Iraqi who'd lost his
legs because of complications from a gunshot
wound. She started to understand that he might
not survive outside the hospital. She described
a creeping feeling of powerlessness. ''You get
to a point when you can't take care of
everybody,'' Kathleen said, her voice quavering.
''It's really tough.'' She knotted and unknotted
her hands, appearing somewhat blank.

Westrup interjected softly, ''Kathleen, are you here?''

''I'm here,'' she said. Then she continued: ''It
got to a point that I was having panic attacks
all the time because we'd get a patient in, and
I'd be thinking, Oh, my God, they're not going
to survive, and how can I help them stop
screaming and not be in pain? It just kept
building up and building up. ...''

Then one day Kathleen's superiors barred her
from visiting the young man who'd had his legs
amputated, suggesting that she was becoming too
emotional. Since the death of the boy named
Mohammed, she had been taking Paxil for
depression, and about the same time, she said,
an Army doctor took her off the medication.

''I went crazy,'' she said plainly. ''I had a
major panic attack. I felt like I couldn't get
enough air.'' On the night it happened, she
climbed the stairs to the hospital's rooftop,
which overlooked the Green Zone. ''We sat up
there millions of times, smoking our cigarettes
or just shooting the breeze and watching the
helicopters coming in and going out. It felt
like a safe place.'' But when a hospital doctor
turned up on the roof, startling her as she
gasped for air, Kathleen began to cry. The
doctor fetched the senior nurse on call.
Believing that Kathleen was contemplating
suicide, the nurse had her evacuated first from
the roof, Kathleen said, and then from Baghdad
altogether.

When I asked if she considered suicide during
her deployment, Kathleen answered: ''Oh, several
times, but I was able to contain those thoughts.
What kept me going was the thought of my
children, and them not being taken care of if I
killed myself.'' She did, however, rehearse some
thoughts about what would happen if she wandered
outside of the Green Zone and deliberately into
enemy fire. ''I was worried about how children
of parents who commit suicide have a higher rate
of suicide themselves. I have three teenagers,
and I'm thinking, I can't do that. But if I died
because of the enemy, then that would be
acceptable. They would be sad, but they could
hold their heads high and say, 'Yes, my mom
served - she gave to this country.'''

Everything that happened to Kathleen - her
feelings of compassion for her Iraqi patients,
the powerlessness she felt in trying to save
them, the depression, Paxil and ultimate
breakdown - all very easily could have happened
to one of her male colleagues. Indeed, she told
me she was not the only soldier feeling great
stress in the hospital: ''We were all facing
these struggles,'' she said. ''There were people
that were breaking down crying, nobody was
sleeping well. There were a lot of nightmares.''
And yet it was Kathleen who was helicoptered out
of the war on a stretcher on April 29 last year
and returned to Oklahoma, to her three-acre
property, her five girls and her husband.

Leaving Iraq and returning home to Oklahoma,
Kathleen felt an instant change in her
relationship with her daughters. ''It was very
difficult for me to see them,'' she told me. ''I
thought I would be excited and run to them and
tell them I loved them, but instead I was
scared. I was scared for them to hold me, to
touch me. I don't know why, because I wanted to
really bad. I was afraid for them to see me
shake or stutter, not being able to
communicate.'' She mentioned, with no small
amount of heartbreak, that it was hard to
reconnect with one particular daughter, who has
dark hair and brown eyes, because ''she looks
like she could be Iraqi.''

Two weeks after arriving in Menlo Park, she was
still baffled by how excruciating family life
had become. When her 9-year-old daughter had
started shouting playfully while being chased by
her 11-year-old in the yard outside, her mind
flashed instantly to Iraq. Kathleen said: ''It
just goes through me and brings me right back. I
have a lot of flashbacks. And then I'd have
nightmares, afraid that they'd hear me talk in
my sleep or yell out, moaning.'' She added, ''Me
and their dad have had nothing but conflict
after conflict, because he wants me to be a
certain way, and I can't.'' Her children, she
said, had begun avoiding her in order not to
upset her, asking their father to drive them
places, speaking quietly in her presence.

Kathleen started seeing an Army psychologist
daily, something she found to be extremely
helpful. A social worker at Fort Sill introduced
the idea that she might be further helped by the
women's residential program in Menlo Park. Yet
having already left her children for most of the
last year, Kathleen was resistant to going.

And then came a turning point. One day, when her
husband was not around to do the driving, she
had the girls in the car on their way to
somebody's team practice, when her 13-year-old
daughter tried to offer some encouragement.
''She said, 'Mama, you can get through this;
it's not like you killed anybody,''' Kathleen
recalled. ''I started crying, and she goes, 'Oh,
my God, you killed somebody!' I went into
another panic attack right in front of my
kids.'' She welled up at the memory, saying:
''That was enough for me. I was like, I'm ready
to go. I'm getting through this.''

So far, however, treatment had been a mixed bag
for Kathleen, mostly because she was homesick
and afraid. She had, however, fostered a great
deal of empathy and respect for the other women
she'd met, understanding that some had lived
with debilitating PTSD for 20 years.

''I came close to leaving here the other day,''
she told me. ''But the girls just surrounded me.
They were like, 'Don't leave.''' The women then
went on to describe how they lived before
treatment - one with security cameras and a
security fence at her house, another locked away
in her apartment, several having lost their
marriages and distanced themselves from their
kids. ''They said: 'You don't want this life. I
would give anything to go back to when my trauma
was new and to get help with it,''' Kathleen
recalled. ''And I could see myself 20 years down
the road; I would be them. And I don't want
that,'' she said. ''I love these girls, but I
don't want that.''

VIII. What the Future Holds

Six weeks later, I flew back to California to
attend the Women's Trauma Recovery Program
graduation. It was held on a Thursday morning in
a wide recreation room on the building's ground
floor. Someone had moved the Ping-Pong table to
one side and dragged a number of chairs into
neat rows. A modest buffet lunch was laid out
along the room's back wall.

The residents took their seats at the front of
the room, having clearly primped for the
occasion. They then read poems, held hands, made
grateful speeches to the staff and, at the end,
played some pensive music on a boombox and bowed
their heads, many of them weeping. It was, of
course, impossible to know what was in store for
any of them. Clearly, they had benefited from
the cohesiveness of the group, having met others
who were wrestling with the same demons.

There was one notable absence - Kathleen, who,
it turned out, left treatment not long after I
met her, presumably to return home to her family
and military life in Oklahoma. Over the next few
months I sent several letters to Kathleen,
hoping to speak with her, but got no response.
Finally, a couple of weeks ago, she called me,
apologizing for her silence. She'd only just
received a medical discharge from the Army and
felt comfortable talking. She had mixed feelings
about leaving the military, since she loved her
work as an Army nurse, but felt that the PTSD
symptoms kept interfering. She'd spent much of
the fall giving vaccinations to soldiers, but
after a soldier passed out one day, causing her
to panic, she realized she was a long way from
being able to handle an urgent medical crisis.

Kathleen also told me that she left Menlo Park
last summer after one of her daughters was
involved in a minor car accident. ''I left
treatment because my children were more
important than my needs,'' she said.

What struck me again and again, meeting and
talking to female Iraq veterans grappling with
PTSD, was their isolation. So many, like
Kathleen, seemed uncertain of what to do next.
It was as if their mistrust of the world had led
them to mistrust themselves. Most were on
antidepressants and were receiving some
counseling through the V.A., but few had a sense
that their symptoms were going away. In
Colorado, Amorita Randall was working to regain
custody of her daughter - a process that she
found discouraging. ''Just because I'm disabled
doesn't mean I can't care for my daughter,'' she
told me. Recently, after months of waiting, Keli
Frasier, the mother in Colorado who had been
struggling with depression, finally managed to
schedule an appointment with a V.A. psychiatrist
to obtain new antidepressants. Across the state
in Denver, Keri Christensen said she was still
haunted by nightmares and unnerved by driving.

And finally, there was Suzanne Swift, who in
early December was given a summary court-martial
at Fort Lewis, a hearing normally used for minor
offenses. As part of a plea bargain, she pled
guilty to ''missing movement'' and being absent
without leave. Her rank was reduced to private,
and she spent the next 21 days, including
Christmas, in a military prison in Washington
State. The Army ruled that in order to receive
an honorable discharge, Swift was dutybound to
complete her five-year enlistment, which ends in
early 2009. After finishing her stint in prison
in January, Swift says she checked herself into
the inpatient psych ward at Fort Lewis's
hospital for a few days but ultimately was
released back to duty. She told me she was
trying generally to ignore the PTSD but had
taken to drinking a lot in order to get by. ''I
kind of liked the Army before all that stuff
happened,'' she said in early February, on the
phone from her barracks at Fort Lewis. ''I was
good at my job. I did what I was supposed to do.
And then in Iraq, I got disillusioned. All of a
sudden this Army you care so much about is like,
well, all you're good for is to have sex with
and that's it.'' She added, ''I really, really,
really, don't want to be here.''

The Army had issued an order for Swift to be
transferred to a base in California later this
spring. Swift was unhappy about the change,
because it would take her farther from her
family in Oregon, but she was also considering
other plans. ''Did you know,'' she said, ''that
there's some program near San Francisco that's
just for women who have PTSD?'' She paused for a
moment, surrounded by the silence in the
barracks at Fort Lewis, then said, ''I'm
thinking about trying to get in there.''

Editors’ Note: March 25, 2007

The cover article in The Times Magazine on March 18 reported on women who served in Iraq, the sexual abuse that some of them endured and the struggle for all of them to reclaim their prewar lives. One of the servicewomen, Amorita Randall, a former naval construction worker, told The Times that she was in combat in Iraq in 2004 and that in one incident an explosive device blew up a Humvee she was riding in, killing the driver and leaving her with a brain injury. She also said she was raped twice while she was in the Navy.

On March 6, three days before the article went to press, a Times researcher contacted the Navy to confirm Ms. Randall’s account. There was preliminary back and forth but no detailed reply until hours before the deadline. At that time, a Navy spokesman confirmed to the researcher that Ms. Randall had won a Global War on Terrorism Expeditionary Medal with Marine Corps insignia, which was designated for those who served in a combat area, including Iraq, or in direct support of troops deployed in one. But the spokesman said there was no report of the Humvee incident or a record of Ms. Randall’s having suffered an injury in Iraq. The spokesman also said that Ms. Randall’s commander, who served in Iraq, remembered her but said that her unit was never involved in combat while it was in Iraq. Both of these statements from the Navy were included in the article. The article also reported that the Navy had no record of a sexual-assault report involving Ms. Randall.

After The Times researcher spoke with the Navy, the reporter called Ms. Randall to ask about the discrepancies. She stood by her account.

On March 12, three days after the article had gone to press, the Navy called The Times to say that it had found that Ms. Randall had never received imminent-danger pay or a combat-zone tax exemption, indicating that she was never in Iraq. Only part of her unit was sent there; Ms. Randall served with another part of it in Guam. The Navy also said that Ms. Randall was given the medal with the insignia because of a clerical error.

Based on the information that came to light after the article was printed, it is now clear that Ms. Randall did not serve in Iraq, but may have become convinced she did. Since the article appeared, Ms. Randall herself has questioned another member of her unit, who told Ms. Randall that she was not deployed to Iraq. If The Times had learned these facts before publication, it would not have included Ms. Randall in the article.